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Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)?

Publication ,  Journal Article
Astroza, GM; Neisius, A; Tsivian, M; Wang, AJ; Preminger, GM; Lipkin, ME
Published in: Int Urol Nephrol
December 2014

PURPOSE: Different factors can determine the outcomes of percutaneous nephrolithotomy (PNL). We analyzed the effect of tract length (TL) on outcomes after PNL. METHODS: We performed a retrospective review of patients undergoing PNL between 2006 and 2011. Patients with preoperative computed tomography (CT), one percutaneous access tract and follow-up imaging within 3 months were included. TL was defined as distance between the skin to the calyx of puncture as measured on preoperative CT. Measurements were independently performed by two urologists and the average was used for analysis. Stone-free rate (SFR) was defined as zero fragments on follow-up imaging. Factors independently associated with the likelihood of being stone-free after PNL were determined using multivariable analysis adjusted for TL, location of access, the presence of incomplete or complete staghorn calculi and type of follow-up imaging. Complications (Clavien score) were independently assessed. RESULTS: A total of 222 patients were included. Median stone burden and body mass index (BMI) was 239.4 mm(2) and 30.5 [interquartile range (IQR): 25.7-36.2]. The median TL was 85.0 mm (IQR: 70.3-100.0) and highly correlated with BMI (ρ = 0.66, p < 0.001). A total of 101 patients (45.5 %) were stone-free. TL was not associated with SFR (p = 0.53). Clavien 1 and 2 complications occurred in 38 (17 %) while Clavien 3 and 4 complications occurred in 17 (8 %) patients. Multivariable analysis revealed no association between complications and TL even when adjusted for gender. CONCLUSIONS: Percutaneous TL is not associated with outcomes of PNL. PNL is a safe and effective treatment for stones in patients with differing body habitus.

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Published In

Int Urol Nephrol

DOI

EISSN

1573-2584

Publication Date

December 2014

Volume

46

Issue

12

Start / End Page

2285 / 2290

Location

Netherlands

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Punctures
  • Nephrostomy, Percutaneous
  • Middle Aged
  • Male
  • Kidney Calculi
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Astroza, G. M., Neisius, A., Tsivian, M., Wang, A. J., Preminger, G. M., & Lipkin, M. E. (2014). Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)? Int Urol Nephrol, 46(12), 2285–2290. https://doi.org/10.1007/s11255-014-0812-0
Astroza, Gaston M., Andreas Neisius, Matvey Tsivian, Agnes J. Wang, Glenn M. Preminger, and Michael E. Lipkin. “Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)?Int Urol Nephrol 46, no. 12 (December 2014): 2285–90. https://doi.org/10.1007/s11255-014-0812-0.
Astroza GM, Neisius A, Tsivian M, Wang AJ, Preminger GM, Lipkin ME. Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)? Int Urol Nephrol. 2014 Dec;46(12):2285–90.
Astroza, Gaston M., et al. “Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)?Int Urol Nephrol, vol. 46, no. 12, Dec. 2014, pp. 2285–90. Pubmed, doi:10.1007/s11255-014-0812-0.
Astroza GM, Neisius A, Tsivian M, Wang AJ, Preminger GM, Lipkin ME. Does the nephrostomy tract length impact the outcomes of percutaneous nephrolithotomy (PNL)? Int Urol Nephrol. 2014 Dec;46(12):2285–2290.
Journal cover image

Published In

Int Urol Nephrol

DOI

EISSN

1573-2584

Publication Date

December 2014

Volume

46

Issue

12

Start / End Page

2285 / 2290

Location

Netherlands

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Punctures
  • Nephrostomy, Percutaneous
  • Middle Aged
  • Male
  • Kidney Calculi
  • Humans